Prostate-specific antigen as a unique routine test in monitoring therapy for inoperable prostate cancer: comparison with radionuclide bone scan and prostatic acid phosphatase

European Urology
M BarichelloS Omacini

Abstract

The aim of the present investigation was the evaluation of cost-effectiveness of variables used in monitoring patients with inoperable prostate cancer. Prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and radionuclide bone scan were considered. The tumor marker positivity was assessed according to dynamic criteria (> 50% increase between consecutive samples). 108 patients entered the study; 72 patients treated with a luteinizing hormone-releasing hormone analogue were followed up for periods ranging from 12 to 64 months. PSA and PAP levels were measured using immunometric assays. Both cutoff-based and dynamic, serial sample-based decision criteria were employed. With respect to a positive bone scan, PSA showed negative predictive values of 82 and 77%, respectively, using 4 and 10 ng/ml as cutoff points. Progression of the disease to the bone occurred in 20 patients: in 17 PSA was the first indicator of progression, in the other 3 PAP anticipated PSA for a very short time (3-4 months), which was not of relevance to clinical decisions. PAP is less specific and sensitive than PSA; PAP may eventually provide information on disease status in a limited percentage of patients with advanced prostate cancer treated wit...Continue Reading

Citations

Jan 30, 1999·Radiographics : a Review Publication of the Radiological Society of North America, Inc·C A LawtonD A Kuban
Jun 1, 1997·The Journal of Bone and Joint Surgery. American Volume·A D Aaron
Aug 29, 2003·The American Journal of Chinese Medicine·Tiing YuMing Liang Hwang
May 10, 2006·Prostate Cancer and Prostatic Diseases·K XuY-C Wong
May 1, 1997·The Urologic Clinics of North America·C T Lee, J E Oesterling
Apr 1, 1997·Seminars in Nuclear Medicine·A Z KrasnowA T Isitman

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